Secondary osteoporosis

Most osteoporosis in older adults is "primary" — linked to aging and, in women, the hormone changes of menopause. Secondary osteoporosis is different: it happens because of an identifiable condition or drug that speeds up bone loss. Examples include long-term glucocorticoid (steroid) use, hyperthyroidism, hyperparathyroidism, chronic kidney disease, celiac disease, rheumatoid arthritis, and certain cancer treatments.

Glucocorticoid-induced osteoporosis is the most common form of secondary osteoporosis. Steroid medications can suppress the cells that build bone and raise fracture risk relatively early in treatment, though some of that risk can lessen after stopping. Anyone on long-term steroids should talk with their doctor about whether a bone density check or fracture risk assessment makes sense.

Tools like FRAX ask about secondary osteoporosis and specific risk factors because these conditions raise fracture risk beyond what a bone density score alone shows. If you have an autoimmune disease, thyroid or parathyroid problem, digestive condition affecting absorption, or take medications linked to bone loss, mention this to your doctor — treating the underlying cause, alongside standard bone care, is usually part of the plan, and all treatment decisions should be made with your prescriber.